Osteomeatal unit OMU

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1 CT Osteomeatal unitomu Assessment of the Relationship between Odontogenic Maxillary Sinusitis and Findings in the Ostiomeatal Unit on Coronal CT Images Miya Kato, Takashi Kaneda, Masataka Kato, Masashi Sakayanagi, Yoshie Yamashita, Yuzo Fujita, Keiko Sekiya, Shintaro Mori and Kaoru Ozawa Background and Objective: The ostiomeatal unitomuincorporates the maxillary sinus ostium, infundibulum, uncinate process, hiatus semilunaris ethmoid bulla, middle turbinate and middle meatus. The maxillary ostium is located in the superior portion of the medial maxillary wall and drains into the posterior aspect of the ethmoid infundibulum. The detailed anatomy of the OMU as displayed by CT provides a road map for surgeons prior to endoscopic sinus surgery. However, little attention has been paid to the relationship between the OMU and odontogenic maxillary sinusitis. This study examined the relationship between the osteomeatal unit and odontogenic maxillary sinusitis using coronal CT images. Subjects and Methods : Materials consisted of 100 abnormal maxillary sinuses in 100 odontgenic maxillary sinusitis patients. Using coronal images, mucosal abnormalities were examined by grading expansion of the low density area, which represents the mucous membranes in the maxillary sinuses. Findings were classified into 3 types and the correlation between obstruction of the maxillary ostium and thickening of other sinonasal sinuses was examined. Results: Results of the grading were as follows: 25 maxillary sinuses were graded as type 1, 22 maxillary sinuses as type 2, and 53 maxillary sinuses as type 3. On pattern analysis using coronal CT images, there were significant differences in obstruction of the maxillary ostium based on thickening of the mucous membranes of the odontgenic maxillary sinusitisp 0.01; also there was a correlation between thickening of the mucous membranes of the ethmoid sinuses and thickening of the mucous membranes of the odontgenic maxillary sinusitisp Thickening of the mucous membranes of both the ethmoid sinuses and frontal sinuses was well correlated with obstruction of the maxillary ostium on coronal CT imagesp However, there was no correlation between obstruction of the maxillary ostium and sphenoid sinuses. Conclusion: Our study indicates that the severity of odontogenic maxillary sinusitis was well correlated with obstruction of the OMU on coronal CT images. Dental Radiology 2007; 472: 4752 Key wordsmaxillary sinus, Osteomeatal unitomu, Mucosal abnormalities, Maxillary sinusitis / Osteomeatal unit OMU Received Feburary 13, revision accepted August 27, From Department of Radiology, Nihon University School of Dentistry at Mastudo, 28701, Sakaecho-Nishi, Matsudo, Chiba , Japan, Ozawa Dental Clinic Address reprint requests to the author, Dr. M. Kato CT 7 47

2 47 2 OMU OMU OMU CT CT 1 OMU CT Vertex kV 80mA FOV25cm3 / 1 Hansberger 1 OMU CT 3 mm WW/WL2500/300 CT 15 1 CT low density area CT Type 1 1/3 Type 2 2/3 Type 3 2/3 Figure 1 CT Type Figure 1CT Type Type 1 1/3 Type 2 2/3 Type 3 2/3 2 p p Type Type Type Figure 2aType Figure 2bType Figure 2cTable Type Type1 5 20Type Type Type1 3 p 0.01 Type Type Type Figure 2aType Type1 3 p 0.01 Table 2 48

3 Figure 2aType 1 CT 33 CT Type 1 low density area Figure 2bType 2 CT 54 CT Type 2 low density area Table 1 Type Type 1 Type 2 Type Figure 2cType 3 CT 41 CT low density areatype 3 low density area p p Table 3 49

4 47 2 Table 2 Type Type 1 n25 Type 2 n22 Type 3 n53 5/2520 8/2532 5/2520 2/258 8/ /2259 2/229 2/229 43/ / /5336 7/5313 p0.01 p0.05 Table / /5636 8/ /4434 6/4413 3/447 p 0.01 p / CT 10 Harnsberger 1 CT OMU low density area 3 Type 1/3 2/3 2/3 CT OMU 1OMU OMU 50

5 OMU OMU CT 2 OMU , CT CT CT OMU OMU 1Harnsberger HR. Handbook of head and neck imaging. 2nd ed. St. Louis: Mosby-Year book. Inc; Zinreich SJ, Kennedy DW, Rosenbaum AE. Paranasal sinuses : CT imaging requirements for endoscopic surgery. Radiology Lang J. Clinical anatomy of the nose, neasal cavity, and paranasal sinuses. New York: Thieme; Van Alayea OE. Nasal sinuses. An anatomic and clinical consideration. Baltimore: Williams and Wilkins Company; Mafee MF. Endoscopic sinus surgery : role of the radiologist. AJNR Am J Neuroradiol Earwaker J. Anatomic variants in sinonasal CT. Radiographics Mafee MF. The Radiologic Clinics of North America. Imaging of the paranasal sinus and oromaxillofacial region. Philadelphia: W.B. Saunders Co Inc

6 A Kurabayashi T, Ida M, Yoshino N, Hosokawa A, Sakaki T, Ishii J, Kishi T, Kusama M. Usefulness of CT images for diagnosis of odontogenic maxillary sinusitis. Oral Radiol Yoshiura K, Ban T, Hijiya K, Miwa K, Ariji E, Tabata O, Araki K, Tanaka T, Yonetsu K, Nakayama E, Ariji Y, Shimizu M, Fujiwara N, Kanda S. Analysis of maxillary sinus using computed tomography. Dentomaxillofac. Radiol Babbael R, Harnsberger HR, Nelson B. Optimization of techniques in screening CT of the sinus. AJR Am J Roentgenology Wallace R, Salazer J, Cowles S. The relationship between frontal sinus drainge and osteomeatal complex disease. AJNR Am J Neuroradiol

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